title: Exercise stress test utility in patients with chest pain presumed to be of cardiac origin.
abstract: BACKGROUND
  NICE stated exercise stress tests (EST) should not be used to diagnose obstructive coronary artery disease in patients presenting with chest pain presumed to be of cardiac origin.
  
  
  METHODS
  A retrospective review of 209 patients with presumed cardiac chest pain was done. EST results, GRACE scores and need for invasive coronary angiogram (ICA) were analysed to predict the need for readmission, intervention and future events.
  
  
  RESULTS
  The sensitivity of the EST in identifying obstructive coronary artery disease was 70%. The EST, ICA and the GRACE 6-month mortality had a 77%, 70% and 81% negative predictive value (NPV) for readmission respectively.
  
  
  CONCLUSIONS
  EST, GRACE scores and ICA are useful in providing prognostic information but are poor predictors of readmission. Follow up and education programmes are needed to reduce this burden.
authors.affiliation: Acute Medical Unit, Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham, B9 5SS.
authors.forename: P
authors.initials: P
authors.lastname: Bennett
authors.forename: P
authors.initials: P
authors.lastname: Dyer
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D002637:Chest Pain; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005080:Exercise Test; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity